Forms

New Clients

If you are a new client, please first make sure you have set an initial appointment. Click here to learn how to set an appointment if you have not already.  Prior to your initial appointment, you will need to complete the new client information forms. These forms consist of background and contact information, disclosure and consent, and assessment to help identify current symptoms and their severity.  These forms typically take 20-30 minutes to complete and can be accessed online through your Counseling Center Student Portal https://actx.medicatconnect.com. To complete these forms, register your account using your ACConnect log-in and password and select the “Forms” tab.

NEW CLIENT INFORMATION FORM

Returning Clients

If you are a returning client, please complete all forms assigned by your counselor prior to each appointment in your Counseling Center Student Portal https://actx.medicatconnect.com under “Forms”. All follow-up forms and assessments take approximately 2-5 minutes each to complete and require the use of a computer for proper formatting. Please answer all questions on required forms and click the Submit button within one hour of your appointment.

To ensure that we are able to provide the highest quality services and use our appointment time effectively, please complete all required forms prior to and within 24 hours of your scheduled session.  If needed, you may arrive early for your scheduled appointment to complete forms using the computer available in the Counseling Center waiting room on the Washington Street Campus, Ware Student Commons First Floor, Room 110.

If you have any questions, please call our office at (806) 371-5900.

Thank you! 

CCAPS-34 & OTHER FORMS

Please report problems with this site or content errors to Connie de Jesus .

Contact Us

Washington Street Campus, Ware Student Commons, First Floor, Room 110
2201 S. Washington St.
Amarillo, TX 79109
Fax: (806) 345-5581

Office Hours

Monday-Thursday: 7:30am - 5:00pm
Friday: 7:30am - 12:00pm

Appointments

Schedule appointments online

Emergency Contact Information

If you are experiencing an emergency situation, please call one of the following:

  • 911 – National Emergency Hotline
  • 988 – Suicide and Crisis Lifeline
  • (806) 371-5911 – Amarillo College Police Emergency